Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | ME-99548 | FL |
NPI | 1013117779 |
---|---|
Provider Name | Dr. Matthew William Carman |
First Address | Brandon, FL 33511-5779 |
Second Address | Brandon, FL 33511-5779 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2007 |
Last Update Date | 20/07/2007 |